Trudy Thomas: Pi­o­neer­ing health ac­tivist

● Trudy Thomas, who has died at the age of 82, was a health ac­tivist and doc­tor who did pi­o­neer­ing com­mu­nity health work in the Eastern Cape un­der apartheid, and was the first health MEC in the post1994 Eastern Cape gov­ern­ment.

She prac­tised pri­mary health­care and com­mu­nity out­reach in ru­ral ar­eas of the Ciskei home­land long be­fore these terms were coined.

In the course of her work she was con­fronted with the full hor­ror of the home­land sys­tem.

She wrote a let­ter to prime min­is­ter Hen­drik Ver­wo­erd pro­vid­ing him with ev­i­dence of its in­hu­man­ity based on her first-hand ex­pe­ri­ence, which she hoped he wouldn’t be able to ig­nore.

He passed it to his wife, Bet­sie, who had trained as a so­cial worker, and who sent Thomas a trite let­ter of sym­pa­thy.

Thomas was born in Krugers­dorp on April 23 1936. Her fa­ther, Ed­win, worked un­der­ground on the gold mines. He’d left school at 12 to sup­port the fam­ily when his fa­ther, a stone­ma­son from Corn­wall who came to South Africa to work on the mines af­ter gold was dis­cov­ered in 1886, died.

Two un­cles on her mother’s side were mem­bers of the pro-Nazi Osse­wabrand­wag, and Afrikaner Weer­stands­be­weg­ing leader Eugene Terre’Blanche was a dis­tant cousin.

Thomas started school at four, ma­tric­u­lated at 15 and went to the Univer­sity of the Wit­wa­ter­srand’s med­i­cal school, where she was one of two women in a class of 120, the rest be­ing white men.

She made fudge and sold it door-to-door to help cover her fees. For the rest she re­lied on bank loans which took her many years to re­pay.

She and her fu­ture hus­band, Ian Har­ris, met over a ca­daver they were dis­sect­ing. A day af­ter grad­u­at­ing they mar­ried and did their in­tern­ship at what was then Barag­wanath Hospi­tal in Soweto.

Her most tragic cases were young men de­lib­er­ately paral­ysed from the neck down to set­tle gang scores. They’d be taken be­hind a mine dump, held face down and told they’d never walk again. Then their spines would be stabbed with sur­gi­cal pre­ci­sion to sever the spinal cord.

There was a whole ward of them at Bara.

She was there in 1960 when scores of women and chil­dren mu­ti­lated by dum­dum bul­lets fired into their flee­ing backs by the po­lice dur­ing the Sharpeville mas­sacre were brought in, so many that they had to put up tents in the grounds to ac­com­mo­date them.

Af­ter com­plet­ing their in­tern­ship in 1961 the cou­ple loaded their car with a new­born daugh­ter and a par­rot that squawked “Ur­gent case, doc­tor!” all the way to St Matthews mis­sion hospi­tal in the Ama­tola moun­tains in the Eastern Cape, which they ran for the next 14 years.

Thomas es­tab­lished a net­work of ru­ral clin­ics in sur­round­ing vil­lages, which she reg­u­larly vis­ited in an an­cient VW Bee­tle. One day, with three small daugh­ters on the back seat, the car got stuck on a nar­row track with a steep in­cline on one side and a sheer drop on the other.

Thomas jumped out, opened the bon­net and was hor­ri­fied to find there was no en­gine. Some men ar­rived, walked round the back and re­vealed to her the “miss­ing” en­gine, which they soon got started.

A grand­mother brought a badly mal­nour­ished in­fant to her.

“Why don’t you feed this child prop­erly?” Thomas asked.

“Doc­tor, be­cause I have no money, no man, no milk,” replied the grand­mother.

It was “the most ex­act so­ciopo­lit­i­cal ex­po­si­tion” she’d ever heard of the ef­fects of mi­grant labour, Thomas wrote in a mem­oir pub­lished last year.

The South African Med­i­cal Jour­nal re­fused to pub­lish a re­port she wrote on the tragic con­se­quences of the home­land pol­icy.

When vac­cines for the most com­mon killer dis­eases, like measles, diph­the­ria and tetanus, be­came avail­able she en­sured that ev­ery child in ev­ery vil­lage was im­mu­nised.

Long be­fore the World Health Or­gan­i­sa­tion “dis­cov­ered” pri­mary health­care in the late ’70s, Thomas was im­ple­ment­ing it. She ini­ti­ated cam­paigns against cer­vi­cal cancer and or­gan­ised vil­lage health work­ers to go to ev­ery house get­ting women to visit their near­est clinic for a Pap smear.

Steve Biko’s wife, Nt­siki, was one of her nurses at St Matthews. When he was banned the se­cu­rity po­lice put pres­sure on Thomas and her hus­band to fire her, which they ig­nored.

When the 1.6m Thomas met Biko, his open­ing line was: “I thought you were big­ger.”

She col­lab­o­rated with Biko and his lover Mam­phela Ram­phele in set­ting up clin­ics and com­mu­nity projects.

In 1979 she started the com­mu­nity health depart­ment at Cecilia Maki­wane Hospi­tal in Mdantsane and ran a net­work of 20 clin­ics.

In 1984 she and her hus­band di­vorced.

Af­ter the ANC was un­banned she headed its Bor­der health desk. Af­ter the 1994 elec­tions Eastern Cape premier Ray­mond Mh­laba made her his health MEC. Her big­gest chal­lenge was uni­fy­ing the Cape Pro­vin­cial Ad­min­is­tra­tion health ser­vices with those in the for­mer home­lands. She found that Ciskei’s well-run mis­sion­ary health ser­vices were in stark con­trast to the “health dis­as­ter” that con­fronted her in the Transkei.

In 1997 Nel­son Man­dela laid the foun­da­tion stone for Mthatha Aca­demic Hospi­tal af­ter Thomas had fought the Na­tional Trea­sury tooth and nail for the money. Ad­dress­ing a packed sta­dium, Man­dela told her to stand, then an­nounced that he had asked the cabi­net for R1-mil­lion for the hospi­tal and they’d agreed.

She re­garded it as one of her proud­est achieve­ments, but when it was com­pleted she was not in­vited to the open­ing. By then her re­la­tion­ship with the ANC had col­lapsed over its re­fusal to al­low her the money she needed to run a de­cent health ser­vice. She said the ANC didn’t care about the poor. In­stead of the im­proved health ser­vice she’d hoped for in the new South Africa there was “a mind­less, rud­der­less, de­cay­ing one”.

She lost her po­si­tion af­ter the 1999 elec­tion and re­signed from the ANC in 2001. She said if she stayed she’d have to “ob­fus­cate about whether HIV caused Aids and con­done the with­hold­ing of pen­sion monies from the el­derly be­cause of po­lit­i­cal and ad­min­is­tra­tive bungling”.

In 2003 Rhodes Univer­sity awarded her an hon­orary doc­tor­ate for her health­care work.

Thomas, who suf­fered from de­men­tia and a stroke in her last 18 months, is sur­vived by four chil­dren.